Armstrong C L, Stern C H, Corn B W
Department of Neurology, University of Pennsylvania Medical School, Philadelphia, USA.
Appl Neuropsychol. 2001;8(3):129-39. doi: 10.1207/S15324826AN0803_1.
Although radiotherapy remains a necessary and frequently used treatmentfor brain tumors, uncertainty remains about the nature and severity of neurocognitive morbidity. We show that verbal-semantic memory (free recall of word list) is sensitive to damaging radiation effects in 20 patients with low-grade, supratentorial, primary brain tumors who received moderate doses of partial-brain irradiation. We previously reported that verbal-semantic memory is dissociated from visual memory (acquisition and recall) during the same phase ofradiation effects, indicating that memory is differentially affected by radiation. In this study, we provide evidence of the nature of the iatrogenic radiation effect on memory by testing collateral cognitive functions that might explain the specific memory impairment. We found that the verbal-semantic recall impairment was not associated with impairments in auditory attention, auditory processing speed, auditory-verbal working memory, or in the temporal coding or subjective organization of word-list recall. These findings focus damaging radiation effects on primary retrievalprocesses, rather than on earlier cognitive processes or executive processes affecting recall. Knowledge of the specific patterns of change in cognition would guide the differential diagnosis and rehabilitation of survivors of brain tumors whose conditions are complicated by tumors with multiple treatments.
尽管放射治疗仍然是脑肿瘤必要且常用的治疗方法，但神经认知发病率的性质和严重程度仍不明确。我们发现，在20例接受中等剂量脑局部照射的幕上低级原发性脑肿瘤患者中，言语语义记忆（自由回忆单词列表）对辐射损伤效应敏感。我们之前报道过，在辐射效应的同一阶段，言语语义记忆与视觉记忆（获取和回忆）相分离，这表明记忆受到辐射的影响存在差异。在本研究中，我们通过测试可能解释特定记忆障碍的附带认知功能，为医源性辐射对记忆的影响性质提供了证据。我们发现，言语语义回忆障碍与听觉注意力、听觉处理速度、听觉言语工作记忆、单词列表回忆的时间编码或主观组织方面的障碍无关。这些发现将辐射损伤效应聚焦于主要的检索过程，而非影响回忆的早期认知过程或执行过程。了解认知变化的具体模式将指导对因肿瘤和多种治疗而病情复杂的脑肿瘤幸存者进行鉴别诊断和康复治疗。
